Tyranny of Cheerfulness

When a major earthquake struck the Bay Area in 1989, I phoned my friend Sue in Oakland to find out if her home had been affected. My call went to voicemail. A positive message, recorded for all their worried out-of-town friends and family, assured: “We’re fine. Everything here is fine.” But the flatlined tone of Sue’s voice alarmed me.

I kept calling, until I got the human Sue, who still sounded like she was in shock. When the earthquake hit, Sue told me, she’d been at a hospital south of San Francisco, trying to find out what was causing her back pain. By chance, at that moment she happened to be alone in a room, inside an MRI machine. If that weren’t bad enough, the quake threw the door’s frame off-kilter, so no one could enter the room for hours to rescue her from the closed box.

Sue’s one of the most straight-shooting people I know, so I’ve often thought about that ‘everything’s fine’ message, and how well we’ve all been trained to give things a cheerful spin. To look on the bright side. To praise things we don’t like. To avoid sadness, fear and despair. Even when it’s not credible. Or what we want to say. Or in our best interest.

The waiter who asks us, “Is everything great?” makes it hard to give any response but a smiling “Yes,” that convinces us we should leave a good tip. Pharmaceutical ads by design channel us into HappyThink. We’re persuaded to believe that we’ll be like the people we see dancing and bicycling across fields of wildflowers, rather than a statistic from the required voice-over warning of death from heart attack, stroke, or sudden bleeding stomach.

I was almost fired from my first job in Boston, as receptionist in Admitting at Children’s Hospital, for endangering lives due to Insufficient Smiling. My supervisor told me that unless I smiled all the time, parents of children with brain tumors were likely to cancel their scheduled brain surgery, and whisk their child home.

But even people who care about us and have good intentions seem to want us to be chronically cheerful. Medical situations or times of loss seem to bring out the worst of that. To the detriment of good health and well-being. And community.

A friend who almost died of a heart attack two weeks ago told me that most people seemed to need her to buck up. She knew they loved her, but it was hard for them to be comfortable with her need to slow down, reflect on her mortality, grieve this change in her heart, consider the choices ahead. I remembered a similar response when I had a miscarriage. How I wanted to hide away when the news was met with a hearty, forward-thinking perspective, or advice that I should find and focus on the silver lining. I didn’t understand why there was a stopwatch on my sorrow, or what was so wrong with the way my feelings could rear up unexpectedly and have their own sense of time and course. Rather than helping, as they were meant, these responses can reinforce isolation.

Waiting rooms in hospitals and clinics cue us to the behavior that’s expected, that keeps the fifteen-minute turn-around of appointments ticking. Too often the artwork displayed is calming to the point of sedation. Patients are dulled, when we need to be alert, thoughtful, able to ask good questions and articulate honestly our concerns and feelings. If we’re feeling despair over our health, it’s important to let the physician know.

On my first visit to a rheumatology clinic, I was terrified. Everything in the waiting room, including the cover of that month’s issue of Arthritis Today, was pink and perky. I found this very agitating. Rather than cheering me up, it made me feel bad about myself for not being cheerful, for having feelings that were off the chart of what was allowed. Even though my feelings were reasonable ones.

I’ve watched a nuclear medicine clinic waiting room change over visits. The first time I was there it was barren. Stoic. Someone on the staff clearly picked up on how that didn’t work, because on my next visit the waiting room was filled with New Yorker magazines. Only The New Yorker. I spent my time there reading the cartoons. That worked better. Last time I was there, there were a range of magazines, including medical journals, which is what I found myself picking up. There was no enforced cheerfulness which I found respectful (really, no one’s sitting in the waiting room of a nuclear medicine clinic without a reason for concern). It felt like what it was, a place to feel comfortable and reflective while you wait to find out news that may not be good.

I think human beings are a resourceful, resilient group, and that when we’re allowed to experience a full range of feelings, we work our way toward the more pleasant ones. But that forced cheerfulness, like false hope, demeans us. I’d agree with my good friend, Rita Arditti, who died a year ago. As the chemo before the last one stopped working I remember her saying, “We’re always looking for hope.” And then she paused, and added the qualification, “hope that’s not stupid.”